Objective:

To determine the cut-off point of obstetric shock index associated with massive transfusion in women with obstetric hemorrhage.

Materials and methods:

We designed a cross-sectional study in women who were admitted to the intensive care unit. The obstetric shock index was calculated at the time of the diagnosis of obstetric hemorrhage. We analyzed vital signs, arterial blood gas, loss of blood, fluid replacement and transfused blood products.

Results:

One hundred and five women with obstetric bleeding were included, in 65 (61%) the obstetric shock index was ≥ 0.9, of whom 38 (58%) needed massive transfusion. Obstetric shock index ≥ 0.9 was significantly associated with massive transfusion (p < 0.001). The blood loss was of 3000 mL (RIC 2000 mL) in the patients with obstetric shock index ≥ 0.9 compared to 2500 mL (RIC 1000 mL) in patients with obstetric shock index < 0.9 (p = 0.04). Women with obstetric shock index ≥ 0.9 showed more significant requirement of transfusion of package red blood (p = 0.03) and platelets (p = 0.01).

Conclusions:

An obstetric shock index ≥0.9 was associated with high transfusión requirements and a higher incidence of serious adverse events, this value is recommended as the cut-off point for predicting the need for massive transfusion.

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